Abstract
The aim of the study was to provide a systematic review and meta-analysis of studies examining the association between mortality risk and motor vehicle crashes (MVCs) in pregnant women compared with nonpregnant women. We used relevant MeSH terms to identify epidemiological studies of mortality risk in relation to MVCs from PubMed, Embase, and MEDLINE databases. The Newcastle–Ottawa Scale (NOS) was used for quality assessment. For comparison of mortality from MVCs between pregnant and nonpregnant women, the pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random effects model. The eight studies selected met all inclusion criteria. These studies included 14,120 injured victims who were pregnant at the time of the incident and 207,935 victims who were not pregnant. Compared with nonpregnant women, pregnant women had a moderate but insignificant decrease in mortality risk (pooled OR = 0.68, 95% CI = 0.38–1.22, I2 = 88.71%). Subgroup analysis revealed that the pooled OR significantly increased at 1.64 (95% CI = 1.16–2.33, I2 < 0.01%) for two studies with a similar difference in the mean injury severity score (ISS) between pregnant and nonpregnant women. Future studies should further explore the risk factors associated with MVCs in pregnant women to reduce maternal mortality.
Highlights
IntroductionPregnancy is a common condition that increases the risk of severe injuries and poor outcomes, including maternal and fetal morbidity and mortality, following trauma [1]
Pregnancy is a common condition that increases the risk of severe injuries and poor outcomes, including maternal and fetal morbidity and mortality, following trauma [1].Pregnant women who experience trauma are at increased health risk because they tend to suffer complications caused by an increase in soft-tissue edema and fluid response, and interpreting their vital signs is difficult due to altered hemodynamics
The inclusion criteria were as follows: (1) studies examined the mortality of motor vehicle crashes (MVCs), and (2) they were conducted on both pregnant women and nonpregnant women
Summary
Pregnancy is a common condition that increases the risk of severe injuries and poor outcomes, including maternal and fetal morbidity and mortality, following trauma [1]. Pregnant women who experience trauma are at increased health risk because they tend to suffer complications caused by an increase in soft-tissue edema and fluid response, and interpreting their vital signs is difficult due to altered hemodynamics. Surgical interventions may be impeded because of their altered anatomy. These factors make trauma during pregnancy challenging to treat, and they contribute to poor adverse outcomes [2]. Even minor injuries may still cause severe adverse pregnancy outcomes because of delayed recognition of pregnancy(especially involving injuries suffered during the first trimester), maternal morbid obesity, and critically injured pregnant women. A previous study suggested that all women of reproductive age should be considered pregnant until proven otherwise [2]
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